Abstract
BackgroundThe thymus arises in the ventral portion of the third and fourth pharyngeal pouch. It descends into the anterior mediastinum at 6th week of gestation. Any errors occurring during this process can cause dissemination of aberrant nodules that are responsible for most atypical thymomas.Case PresentationThe authors report a unusual case of type-A thymoma located in D10 and D11 vertebral bodies.The histology showed a uniform growth of short, spindle shaped, mitotically inactive cells. A few small, normal lymphocytes were seen scattered or in small groups. The immunohistochemical investigation for neuroectodermal, neuroendocrine, vascular and muscular markers were negative. It also confirmed the presence of CD3+, CD5+ T lymphocytes and the absence of immature T-lymphocyte markers.ConclusionsThe case described shows a thymic hystogenesis for spindle cell tumours. To our knowledge no other cases of vertebral thymomas have been described in international literature.
Highlights
Backgroud The thymus arises in the ventral portion of the third and fourth pharyngeal pouch
It descends into the anterior mediastinum at 6th week of gestation
Any errors occurring during this phase can cause dissemination of aberrant nodules that are responsible for most uncommon thymomas [1]
Summary
A variety of tumours occur, the majority of them are of neurogenic origin, schwannomas and neurofibromas being the most frequently encountered neoplasms [6]. The diagnosis of Chordoma was excluded basing on FDG-PET activity as well as plasmocitoma that should have had no hyperfissation period in bone scan and high activity in FDG-PET In this case, the possibility of a synovial sarcoma was ruled out by the bland appearance of the nuclei, but by the lack of mitotic activity and the absence of the SYT translocation typically associated to Synovial sarcoma, as demonstrated by the FISH investigation. In our case the lesion is clearly located in vertebral body and not in the posterior mediastinum, the bland appearance of the fusiform nuclei, the presence of scattered typical lymphocytes, the presence of peri-vascular spaces as typical for thymic epithelial tumours (TET), the strong collagen IV deposits among the spindle cells and the extensive coexpression of cytokeratins and CD20 were considered highly diagnostic for type A thymoma according to the World Class Organization classification system of TET [8].
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